| NPI | 1356062061 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RITCHINA LUKES-MILLEDGE Nurse Practitioner 631-824-6648 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health |
| Enumeration Date | 2022-09-09 |
| Last Update Date | 2024-06-12 |